The problem

The, then clinical commissioning group (CCG), now the integrated care board (ICB), needed to redesign the payment process for primary care because otherwise the payments would be confusing, time consuming and in some cases unfair.

The challenge

How might we move away from a model based on the outdated national contract formula and many additional separate payments for additional services so that we have a much simpler payment model which encompasses all funding streams and recognisees individual patient need at practice level

How might we fund primary care based upon need as it impacts on primary care delivery and to base this as far as possible on NHS Leicester, Leicestershire and Rutland (LLR) CCG, now ICB,  patient level data so that we have a reflective funding model that brings funding equity also we do not have to wait years for updates to the national funding model and data, as our population health priorities change and patient data adapts, we can refresh the model on a regular basis.

The outputs

The new funding model:

• in comparison to the national funding, offered over 10% increases in the practices with a high index of multiple deprivation.
• allowed us to level up funding based on need,
• over time, will see increases in the key determinants of population health but particularly reductions in the health inequalities.
• a consistent offer of services across all LLR practices with the impact being a reduced level of referrals to secondary care or other providers and better outcomes

The outcomes

The benefits to the system as a result of the funding change were:

• creation of a practice baseline against which to track performance,
• improvements in patient outcomes and experience
• ability to incorporate local data in the local distribution of national funding.